Treating Acute Toxo-Metabolic Encephalopathy With Continuous Renal Replacement Therapy: A Case Report of Ifosfamide Neurotoxicity.

Acute toxometabolic encephalopathy, which encompasses delirium and the acute confusional state, is a condition of global cerebral dysfunction in the absence of primary structural brain disease. Ifosfamide is an alkylating agent used in chemotherapy for the treatment of hematological and various solid tumors and is associated with dose-dependent central nervous system toxicity. We report a case of a patient who developed severe neurological symptoms and encephalopathy after receiving Ifosfamide, a chemotherapy agent. Despite initial management with intravenous methylene blue, the patient continued to deteriorate. Initiation of continuous venovenous hemodialysis 14 hours after symptom onset resulted in rapid and complete recovery.